2014Optometry and Vision ScienceOpen access

A New Slit Lamp–Based Technique for Anterior Chamber Angle Estimation

Joan Gispets, Genı́s Cardona, Núria Tomás, Cèlia Fusté, Alison M. Binns, Miguel A. Fortes

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Abstract

PURPOSE: To design and test a new noninvasive method for anterior chamber angle (ACA) estimation based on the slit lamp that is accessible to all eye-care professionals. METHODS: A new technique (slit lamp anterior chamber estimation [SLACE]) that aims to overcome some of the limitations of the van Herick procedure was designed. The technique, which only requires a slit lamp, was applied to estimate the ACA of 50 participants (100 eyes) using two different slit lamp models, and results were compared with gonioscopy as the clinical standard. RESULTS: The Spearman nonparametric correlation between ACA values as determined by gonioscopy and SLACE were 0.81 (p < 0.001) and 0.79 (p < 0.001) for each slit lamp. Sensitivity values of 100 and 87.5% and specificity values of 75 and 81.2%, depending on the slit lamp used, were obtained for the SLACE technique as compared with gonioscopy (Spaeth classification). CONCLUSIONS: The SLACE technique, when compared with gonioscopy, displayed good accuracy in the detection of narrow angles, and it may be useful for eye-care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

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PURPOSE: To design and test a new noninvasive method for anterior chamber angle (ACA) estimation based on the slit lamp that is accessible to all eye-care professionals. METHODS: A new technique (slit lamp anterior chamber estimation [SLACE]) that aims to overcome some of the limitations of the van Herick procedure was designed. The technique, which only requires a slit lamp, was applied to estimate the ACA of 50 participants (100 eyes) using two different slit lamp models, and results were compared with gonioscopy as the clinical standard. RESULTS: The Spearman nonparametric correlation between ACA values as determined by gonioscopy and SLACE were 0.81 (p < 0.001) and 0.79 (p < 0.001) for each slit lamp. Sensitivity values of 100 and 87.5% and specificity values of 75 and 81.2%, depending on the slit lamp used, were obtained for the SLACE technique as compared with gonioscopy (Spaeth classification). CONCLUSIONS: The SLACE technique, when compared with gonioscopy, displayed good accuracy in the detection of narrow angles, and it may be useful for eye-care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

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Available abstract

PURPOSE: To design and test a new noninvasive method for anterior chamber angle (ACA) estimation based on the slit lamp that is accessible to all eye-care professionals. METHODS: A new technique (slit lamp anterior chamber estimation [SLACE]) that aims to overcome some of the limitations of the van Herick procedure was designed. The technique, which only requires a slit lamp, was applied to estimate the ACA of 50 participants (100 eyes) using two different slit lamp models, and results were compared with gonioscopy as the clinical standard. RESULTS: The Spearman nonparametric correlation between ACA values as determined by gonioscopy and SLACE were 0.81 (p < 0.001) and 0.79 (p < 0.001) for each slit lamp. Sensitivity values of 100 and 87.5% and specificity values of 75 and 81.2%, depending on the slit lamp used, were obtained for the SLACE technique as compared with gonioscopy (Spaeth classification). CONCLUSIONS: The SLACE technique, when compared with gonioscopy, displayed good accuracy in the detection of narrow angles, and it may be useful for eye-care clinicians without access to expensive alternative equipment or those who cannot perform gonioscopy because of legal constraints regarding the use of diagnostic drugs.

Key concepts: Gonioscopy, Slit lamp, Anterior chamber angle, Ophthalmology, Glaucoma, Optometry, Optics, Slit

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